Written asthma action plan for children

The principles of asthma action plans for children also apply to adolescents.

All children with asthma or recurrent wheeze should have a written asthma action plan. The asthma action plan should include:

• the usual preventer and reliever drug regimen
• how to recognise symptoms of asthma deterioration
• when to start or change reliever and preventer therapy, and when to start oral corticosteroid therapy
• when to seek medical attention
• details of the child’s emergency contact.

Review the written asthma action plan whenever therapy is changed, and at least every 6 months.

Asthma action plans detail steps for adjusting drug therapy that should be followed when symptoms occur, according to the severity and duration of symptoms. Individualise the plan to the patient’s current treatment regimen, their usual asthma symptoms and pattern of reliever use, and their willingness and ability to self-manage worsening asthma. Also consider the patient’s history of exacerbations, including the severity and their ability to seek appropriate medical attention. Asthma action plan templates are available on the National Asthma Council Australia website.

For a mild, transient increase in symptoms, the action plan should recommend that the patient use their reliever therapy. If the symptoms respond well and do not recur, this step is enough.

For a nonurgent but persistent increase in symptoms (eg requiring reliever more than three times per week, symptoms recurring within a few hours of reliever therapy, asthma interfering with daily activities), the action plan should recommend a short course of oral prednisolone (or prednisone) (in addition to using reliever therapy). This can prevent progression to an acute exacerbation. Use: